Knowledge Is Power Safety, Post-Menopause Too

Note: this article will be most relevant for a subset of our subscribership, but it’s a very large subset, so we’re going to go ahead and address the reader as “you”.

If, for example, you are a man and this doesn’t apply to you, we hope it will interest you anyway (we imagine there are women in your life).

PS: the appendicitis check near the end, works for anyone with an appendix

We’ve talked before about things that come with (and continue after) menopause:

• What You Should Have Been Told About The Menopause Beforehand
• What Menopause Does To The Heart
• Alzheimer’s Sex Differences May Not Be What They Appear

But what’s going on if certain menstrual symptoms reappear post-menopause (e.g. after more than a year with no menstruation)?

Bleeding

You should not, of course, be experiencing vaginal bleeding post-menopause. You may have seen “PSA” style posts floating around social media warning that this is a sign of cancer. And, it can be!

But it’s probably not.

Endometrial cancer (the kind that causes such bleeding) affects 2–3% of women, and of those reporting post-menopausal bleeding, the cause is endometrial cancer only 9% of those times.

So in other words, it’s not to be ignored, but for 9 people out of 10 it won’t be cancer:

Read more: Harvard Health | Postmenopausal bleeding: Don’t worry—but do call your doctor

Other more likely causes are uterine fibroids or polyps. These are unpleasant but benign, and can be corrected with surgery if necessary.

The most common cause, however is endometrial and/or vaginal atrophy resulting in tears and bleeding.

Tip: Menopausal HRT will often correct this.

Read more: The significance of “atrophic endometrium” in women with postmenopausal bleeding

(“atrophic endometrium” and “endometrial atrophy” are the same thing)

In summary: no need to panic, but do get it checked out at your earliest convenience. This is not one where we should go “oh that’s weird” and ignore.

Cramps

If you are on menopausal HRT, there is a good chance that these are just period cramps. They may feel different than they did before, because you didn’t ovulate and thus you’re not shedding a uterine lining now, but your body is going to do its best to follow the instructions given by the hormones anyway (hormones are just chemical messengers, after all).

If it is just this, then they will probably settle down to a monthly cycle and become quite predictable.

Tip: if it’s the above, then normal advice for period cramps will go here. We recommend ginger! It’s been found to be as effective as Novafen (a combination drug of acetaminophen (Tylenol), caffeine, and ibuprofen), in the task of relieving menstrual pain:

See: Effect of Ginger and Novafen on menstrual pain: A cross-over trial

It could also be endometriosis. Normally this affects those of childbearing age, but once again, exogenous hormones (as in menopausal HRT) can fool the body into doing it.

If you are not on menopausal HRT (or sometimes even if you are), uterine fibroids (as discussed previously) are once again a fair candidate, and endometriosis is also still possible, though less likely.

Special last note

Important self-check: if you are experiencing a sharp pain in that general area and are worrying if it is appendicitis (also a possibility), then pressing on the appropriately named McBurney’s point is a first-line test for appendicitis. If, after pressing, it hurts a lot more upon removal of pressure (rather than upon application of pressure), this is considered a likely sign of appendicitis. Get thee to a hospital, quickly.

And if it doesn’t? Still get it checked out at your earliest convenience, of course (better safe than sorry), but you might make an appointment instead of calling an ambulance.

Take care!

For you personally, that is—so let’s look at some options, their benefits, and what kind of person is most likely to benefit from each.

Yoga is, of course, an ancient practice, and like any ancient practice, especially one with so many practitioners (and thus also: so many teachers), there are very many branches to the tree of variations, that is to say, different schools and their offshoots.

Since we cannot possibly cover all of them, we’ll focus on five broad types that are popular (and thus, likely available near to you, unless you live in a very remote place):

Hatha Yoga

This is really the broadest of umbrella categories for yoga as a physical practice of the kind that most immediately comes to mind in the west:

• Purpose: energizes the practitioner through controlled postures and breath.
• Practice: non-heated, slow asanas held for about a minute with intentional transitions
• Benefits: reduces stress, improves flexibility, tones muscles, and boosts circulation.
• Best for: beginners with an active lifestyle.

Vinyasa Yoga

You may also have heard of this called simply “Flow”, without reference to the Mihaly Csikszentmihalyi sense of the word. Rather, it is about a flowing practice:

• Purpose: builds heat and strength through continuous, flowing movement paired with breath.
• Practice: dynamic sequences of the same general kind as the sun salutation, leading to a final resting pose.
• Benefits: enhances heart health, strengthens core, tones muscles, and improves flexibility.
• Best for: beginner to intermediate yogis seeking a cardio-based practice.

Hot Yoga

This one’s well-known and the clue is in the name; it’s yoga practised in a very hot room:

• Purpose: uses heat to increase heart rate, and loosen muscles.
• Practice: heated studio (32–42℃, which is 90–108℉), often with vinyasa flows, resulting in heavy sweating*
• Benefits: burns calories, improves mood, enhances skin, and builds bone density.
• Best for: intermediate yogis comfortable with heat; not recommended for certain health conditions.

*and also sometimes heat exhaustion / heat stroke. This problem arises most readily when the ambient temperature is higher than human body temperature, because that is the point at which sweating ceases to fulfil its biological function of cooling us down.

Noteworthily, a study found that doing the same series of yoga postures in the same manner, but without the heat, produced the same health benefits without the risk:

❝The primary finding from this investigation is that the hatha yoga postures in the Bikram yoga series produce similar enhancements in endothelium-dependent vasodilatation in healthy, middle-aged adults regardless of environmental temperature. These findings highlight the efficacy of yoga postures in producing improvements in vascular health and downplay the necessity of the heated practice environment in inducing vascular adaptations.❞

Source: Effects of yoga interventions practised in heated and thermoneutral conditions on endothelium-dependent vasodilatation: The Bikram yoga heart study

(“Bikram yoga” is simply the brand name of a particular school of hot yoga)

Yin Yoga

This is a Chinese variation, and is in some ways the opposite of the more vigorous forms, being gentler in pretty much all ways:

• Purpose: promotes deep tissue stretching and circulation by keeping muscles cool.
• Practice: passive, floor-based asanas held for 5–20 minutes in a calming environment.
• Benefits: increases flexibility, enhances circulation, improves mindfulness, and emotional release.
• Best for: all levels, regardless of health or flexibility.

Restorative Yoga

This is often tailored to a specific condition, but it doesn’t have to be:

• Purpose: encourages relaxation and healing through supported, restful poses.
• Practice: reclined, prop-supported postures in a soothing, low-lit setting.
• Benefits: relieves stress, reduces chronic pain, calms the nervous system, and supports healing.
• Best for: those recovering from illness/injury or managing emotional stress.

See for example: Yoga Therapy for Arthritis: A Whole-Person Approach to Movement and Lifestyle

Want to know more?

If you’re still unsure where to start, check out:

Yoga Teacher: “If I wanted to get flexible (from scratch) in 2025, here’s what I’d do”

Take care!